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Achieving Glycaemic Control with Concentrated Insulin in Patients with Type 2 Diabetes.

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posted on 2019-04-30, 13:17 authored by Sudesna Chatterjee, Kamlesh Khunti, Melanie J. Davies
The recent introduction of the second-generation long-acting analogue insulins degludec and insulin glargine U300 have increased the choice of basal insulin therapy for patients with type 2 diabetes. The pharmacokinetic and pharmacodynamic properties of these insulins result in a flatter profile that lasts over 24 h and provides an increased window of administration of 6 h once daily. Large-scale multicentre randomised clinical trial programmes (BEGIN for degludec U100 and U200 and EDITION for glargine U300) evaluating these insulin therapies against glargine U100 have demonstrated that they are either non-inferior or superior for glycaemic efficacy and safety, but less likely to result in severe or nocturnal hypoglycaemia than glargine U100. The disposable pen devices for these insulins have been designed with patient satisfaction and convenience in mind. No concerns have arisen with adverse events with insulin analogues or cardiovascular safety from the ORIGIN and DEVOTE trials. As they demonstrate equivalent glycaemic efficacy to other basal insulins, they should be considered more in selected patient groups including those with recurrent or increased risk of hypoglycaemia, especially severe or nocturnal episodes, in the elderly or those living alone, and in patients with multiple co-morbidities such as cardiovascular or renal disease.

Funding

The authors acknowledge support from the National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care—East Midlands (NIHR CLAHRC—EM), the Leicester Clinical Trials Unit and the NIHR Leicester Biomedical Research Centre, which is a partnership between University Hospitals of Leicester NHS Trust, Loughborough University and the University of Leicester.

History

Citation

Drugs, 2019, 79 (2), pp. 173-186

Author affiliation

/Organisation/COLLEGE OF LIFE SCIENCES/School of Medicine/Diabetes Research Centre

Version

  • AM (Accepted Manuscript)

Published in

Drugs

Publisher

Springer Verlag (Germany), Adis

eissn

1179-1950

Copyright date

2019

Publisher version

https://link.springer.com/article/10.1007/s40265-018-1048-6

Notes

The ​original ​version ​of ​this ​article ​was ​revised: Due to Section 4.1 third paragraph update. A correction to this article is available online at https://doi.org/10.1007/s40265-019-1063-2. A correction to this article is available online at https://doi.org/10.1007/s40265-019-01094-0.;The file associated with this record is under embargo until 12 months after publication, in accordance with the publisher's self-archiving policy. The full text may be available through the publisher links provided above.

Language

en

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